| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE | — | $97K | $97K | 3.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC | $32K | — | $32K | 3.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | DELTA DENTAL OF CALIFORNIA | $10K | — | $10K | 4.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $22K | $5K | $27K | 13.57% |
| COMPSYCH5 | 455 N CITYFRONT PLAZA DR, 13TH FL CHICAGO, IL 90611 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 1.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | EYEMED VISION CARE | $3K | — | $3K | 9.97% |
| FLEXVISION - MD3 | 15400 CALHOUN DR. ROCKVILLE, MD 20855 | EYEMED VISION CARE | — | $570 | $570 | 2.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | DELTA DENTAL OF CALIFORNIA | $529 | — | $529 | 4.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 254 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 164 | $3.7M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 205 | $230K |
| Vision | EYEMED VISION CARE | 349 | $26K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 254 | $196K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 254 | $196K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 164 | $3.7M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 254 | $196K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 349 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.